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“If I Get Cured, My Whole Quality of Life Will Change”: Patients’ Anticipated and Actualized Benefits Following Cure from Chronic Hepatitis C

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Abstract

Background

Patients’ motivations for undergoing direct-acting antiviral (DAA) therapy for chronic hepatitis C may include anticipation of treatment benefits not well described in the literature.

Aims

Evaluate patients’ anticipated and actualized improvements in several domains of functioning before and after viral cure.

Methods

Pre–post-study utilizing in-depth interviews with 28 patients prior to, and several months after, DAA therapy. Interviews were audio-recorded, transcribed, coded, and analyzed by two qualitative experts.

Results

Patients had a median age of 54 years, 43% were male, 57% white, 25% had cirrhosis, and 71% were treated with sofosbuvir/ledipasvir. Pre-treatment, patients hoped for improvements in several domains including psychological, emotional, physical, social, and occupational functioning. After viral cure, increased energy and less fear of transmission were pathways to better quality of life. Psychological and emotional improvements positively affected physical, social, and occupational functioning. Social improvements were due to better mood and motivation, fewer symptoms, and reduced fear of stigma and transmission. Occupational benefits were linked to increased stamina, self-confidence, and less pain, anxiety, and stigma. Reduced fear of stigma had a pervasive impact on all life improvements after cure. Patient characteristics such as the presence of cirrhosis or psychiatric issues influence treatment motivations. Qualitative data correspond with change in pre–post-survey scores.

Conclusions

Tremendous hope is placed on the ability of DAA therapy to bring about substantial improvements in life functioning after viral cure. Highly interconnected effects on quality of life worked synergistically through improved physical and psychological well-being. Stakeholders should appreciate the multi-dimensional benefits that viral eradication bestows upon individuals and society.

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Funding

This study was funded by Gilead Sciences, Inc. This work was supported, in part, by the following: (1) University of North Carolina at Chapel Hill’s Connected Health Applications and Interventions Core (CHAI Core) through a grant from NIH (DK056350) to the University of North Carolina Nutrition Obesity Research Center and/or from NCI (P30-CA16086) to the Lineberger Comprehensive Cancer Center; (2) the University of North Carolina at Chapel Hill Center For AIDS Research (CFAR), an NIH funded program (P30 AI050410); (3) a training grant from the NIH (T32 DK007634); and (4) the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health, through Grant Award Number UL1TR002489.

Author information

Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, Burnett-Womack Building CB #7584, Chapel Hill, NC, 27599, USA

    Donna M. Evon & Michael W. Fried

  2. Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, 130 Mason Farm Road, Bioinformatics Building CB #7080, Chapel Hill, NC, 27599, USA

    Hannah P. Kim

  3. Division of Global Health and Infectious Disease, Department of Medicine, University of North Carolina, 130 Mason Farm Road, Bioinformatics Building, Chapel Hill, NC, 27599, USA

    Angela Edwards

  4. Institute for Global Health and Infectious Diseases, Connected Health Applications and Interventions Core, University of North Carolina, 130 Mason Farm Road, Bioinformatics Building CB #7030, Chapel Hill, NC, 27599, USA

    Jessica Carda-Auten

  5. Department of Population Health Sciences and Department of Pediatrics, Duke University School of Medicine, 215 Morris Street, Suite 230 DUMC 104023, Durham, NC, 27701, USA

    Bryce B. Reeve

  6. Division of General Medicine and Clinical Epidemiology, Department of Medicine, Department of Health Behaviors, University of North Carolina, 135 Dauer Drive CB #7440, Chapel Hill, NC, 27599, USA

    Carol E. Golin

Authors
  1. Donna M. Evon
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  2. Hannah P. Kim
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  3. Angela Edwards
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  4. Jessica Carda-Auten
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  6. Carol E. Golin
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  7. Michael W. Fried
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Corresponding author

Correspondence to Donna M. Evon.

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Conflict of interest

Donna M. Evon has received research funding from Gilead Sciences, Inc. and Merck Sharp and Dohme. Michael W. Fried has received research funding from and served as a consultant for AbbVie, BMS, Gilead, Merck, and TARGET PharmaSolutions. Stock in TARGET PharmaSolutions is held in an independently managed trust. Angela Edwards, Jessica Carda-Auten, Bryce B. Reeve, Carol E. Golin, and Hannah P. Kim declare that they have no conflict of interest.

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Evon, D.M., Kim, H.P., Edwards, A. et al. “If I Get Cured, My Whole Quality of Life Will Change”: Patients’ Anticipated and Actualized Benefits Following Cure from Chronic Hepatitis C. Dig Dis Sci 67, 100–120 (2022). https://doi.org/10.1007/s10620-021-06829-2

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  • DOI: https://doi.org/10.1007/s10620-021-06829-2

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